Coughing in Surgery — Case | Urology | SMLE Q#5893

SMLE Question #5893

Surgery Urology

Objective: OBJ-124

Last updated: February 2026
A 58-year-old postmenopausal woman has 6 months of sudden strong urinary urgency that is difficult to defer, followed by urine leakage if she cannot reach the toilet. She voids 12–14 times daily and has nocturia 3 times nightly. She denies leakage with coughing, sneezing, or lifting. Pelvic examination shows no significant prolapse. After counseling on bladder training and limiting caffeine/fluids, which of the following is the most appropriate initial pharmacologic management?

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